Prehab

[David Sanders]

So, I have recently been diagnosed with upper cross syndrome. This is causing some issues with my bench press due to shoulder instability and with my squat due to severely limited external rotation. I am determined to drive on. My question is: should I drop my normal NLP workout on Wednesday to focus on rehab exercises (rhomboids, lower traps, etc.) IOT correct the problem or should I drive on with the 3 x a week NLP workouts and find another time to squeeze in the corrective training?

[Michael Wolf]

A well timed release of this article for you, sir: Hauntological Corrective Exercise: A Critique and the Implications of Physical Therapy

We know from this longitudinal study [13] that back pain is not correlated with posture, spinal mobility, or physical activity. One would think this would stop the OAs from worrying about posture, but these spirited folks still put clients through postural rigmarole with labels like Upper-Crossed Syndrome (and Lower-Crossed Syndrome).

UCS is an absurdly complicated phenomenon that essentially means the subject’s head and shoulders are forward. Yet, when Lab Coats attempt to define normal positions v. abnormal positions, they cannot agree because of the natural variation humans display. If we cannot definitively state where one’s shoulders should be, how do we know they are forward, and to what degree? Furthermore, what is the root cause of this non-existent problem?

Why, it’s muscular imbalance, of course. However, all the data shrugs its terribly rounded shoulders when it is asked what exactly is imbalanced and by how much. The Lab Coats have tried to define muscular balance for decades, but they cannot agree on strength standards or ratios, what constitutes a “tight” or “loose” muscle, or possible correlations between muscular strength and weakness and pain or injury.

The gist of Paul Ingraham’s great article [14] on postural science: we cannot define poor posture because of the innate variability of human anthropometry and kinetics. Therefore, diagnoses that address specific symptoms are spurious, and various “treatments” of the symptoms we perceive as poor posture are not effective. It’s quite difficult to fix something if we can’t determine how it should and should not be operating. The good news: posture doesn’t really matter.

[David Sanders]

THANKS!!

[Michael Wolf]

To be a little more specific, David:

If you can't get into a certain ROM to successfully complete a correctly executed barbell lift, and it's not because of a permanent anatomical/bony structure issue, then you may be able to stretch or do something to get into that position and ROM. And you should. But aside from that, strength + awareness of your body position will do more to improve all that other stuff, than the typical isolated PT stuff you'll get from 99.9% of physical therapists, functional trainers, etc.

[David Sanders]

Yeah, I'm in the Army and a buddy of mine is a PT tech. He told me essentially the same thing and even states that the "physical therapy" type exercise are not beneficial here. He recommended strengthening exercises such as chin ups, lat pull downs, rows, etc. with an emphasis maintaining scapular retraction.and recession and then follow up with stretches now that the muscles are warm. So, should to find this legit, if so, should I squeeze these in where I can or replace a workout each week until ROM improves?

[Michael Wolf]

It probably won't hurt to throw in some chins or pulldowns right off the bat instead of a few weeks or so in, so just make that part of the workout, alternating with deadlifts from the get-go. Add rows in at the end of the workout after a couple months. Stretch a little at the end, if you want to, unless you can't achieve full ROM per my earlier post, in which case you have to. Prioritize the workouts.

[David Sanders]

Thanks coach! Truly appreciated!!